Effects of cholinesterase deficiency under local anesthesia
With local anaesthesia, a cholinesterase deficiency has the consequence that certain local anaesthetics are broken down more slowly. This results in a prolonged anaesthesia of the region, but the fact that the drug has a longer duration of action in the body can also lead to further side effects. If there is a deficiency of a related enzyme, namely pseudocholinesterase, the local anaesthetic may also have a longer duration of action.
These drugs must not be given in case of cholinesterase deficiency
In the case of cholinesterase deficiency, local anaesthetics should be administered with caution or those that are broken down by another mechanism should be used. In addition, muscle relaxants other than succinyl-type anesthetics should be used during anesthesia to prevent prolonged paralysis of breathing after completion of the operation. Other drugs such as the contraceptive pill, certain glaucoma drops, anticholinergics or high-dose glucocorticoids can also have a negative effect.
Diagnosis of cholinesterase deficiency
Cholinesterase can be determined in the blood and this is how the diagnosis of cholinesterase deficiency is made. It is important to note that in most cases the cholinesterase level is reduced due to an underlying liver-damaging disease. Only in the case of a congenital cholinesterase deficiency is another clinical picture not necessarily present simultaneously. The normal values for cholinesterase are different for women and men, as well as children and pregnant women.
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